Iggy Chpt 55 Bowel questions Flashcards
A client has a routine sigmoidoscopy. What common complication is the nurse looking for in a postprocedure assessment?
A) Excessive diarrhea B) Heavy bleeding C) Nausea and vomiting D) Severe rectal pain
B
Excessive or heavy bleeding is a possible complication following a sigmoidoscopy. It must be reported immediately to the health care provider.
Which factors place the client at risk for GI problems? Select all that apply.
A) Eating a high-fiber diet B) Smoking a half-pack of cigarettes per day C) Socioeconomic status D) Some herbal preparations E) Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
B, C, D, E
B) Smoking or any tobacco use places a client in a higher risk category for GI problems.
C) Socioeconomic status can influence the risk for GI problems. Clients may not be able to afford to seek care and may put off seeking help. They may not be able to afford treatments or therapeutic diets.
D) Some herbal preparations contribute to GI problems. Ayurvedic herbs can affect appetite, absorption, and elimination.
E) NSAIDs can predispose clients to peptic ulcer disease or GI bleeding.
Incorrect: A diet that is high in fiber does not place a client at risk for developing a GI disturbance. High-fiber diets are generally believed to be healthy for most clients.
A client is scheduled for a colonoscopy. What does the nurse tell the client to do before the procedure is performed?
A) "Begin a clear liquid diet 12 to 24 hours before the test." B) "Do not eat or drink anything for 12 hours before the test." C) "Give yourself tap water enemas until the fluid returns are clear." D)"You will have to drink a contrast liquid 2 hours before the test."
A
The client is instructed to be on a liquid diet for 12 to 24 hours before a colonoscopy.
A client with newly diagnosed irritable bowel syndrome (IBS) reports having five to six loose stools daily. What is the common psychological client response to this GI health problem?
A) Acceptance B) Embarrassment C) Euphoria D) Grief
B
The client who has a new onset of IBS with frequent stools most likely would be embarrassed.
Which substance, produced in the stomach, facilitates the absorption of vitamin B12?
A) Glucagon B) Hydrochloric acid C) Intrinsic factor D) Pepsinogen
C
Parietal cells in the stomach produce intrinsic factor, a substance that facilitates the absorption of vitamin B12. Absence of the intrinsic factor causes pernicious anemia.
What is a common GI problem that older adult clients experience more frequently as they age?
A) Decreased hydrochloric acid B) Excess lipase production C) Increased liver enzymes D) Increased peristalsis
A
Atrophy of the gastric mucosa causes a decreased ratio of gastrin-secreting cells to somatostatin-secreting cells. This results in a decrease in hydrochloric acid, causing decreased absorption of iron and vitamin B12.
A 49-year-old woman comes to the emergency department (ED) with reports of black tarry stools that started 2 weeks ago. In taking a GI history, which questions does the nurse ask that pertain to Gordon’s Functional Health Patterns? Select all that apply.
A) "Are you having any difficulty having sex? How frequently do you have sex?" B) "Do you have any difficulty chewing or swallowing?" C) "Do you have pain, diarrhea, gas, or any other problems? Do any specific foods cause these symptoms for you?" D) "What is your usual bowel elimination pattern? Frequency? Character?" E) "When was your last colonoscopy?"
B,C,D,E
A client is admitted to the hospital with severe right upper quadrant (RUQ) abdominal pain. Which assessment technique does the nurse use for this client?
A) Assesses the abdomen in the following sequence: inspection, palpation, percussion, auscultation B) Examines the right upper quadrant (RUQ) of the abdomen last C) Has the client lie in a supine position with legs straight and arms at the sides D) Views the abdomen by looking directly down while standing over the client's abdominal area
B
The client reports pain in the RUQ, so the nurse would examine this area last in the examination sequence. This sequence prevents the client from tensing abdominal muscles because of the pain, which would make the examination difficult.
A client is admitted to the hospital with elevated serum amylase and lipase levels and a decreased calcium level. Which GI health problem is indicated by these laboratory findings?
A) Acute pancreatitis B) Cirrhosis C) Crohn's disease D) Diarrhea
A
These laboratory values are commonly found in clients with acute pancreatitis.
A nurse is assessing a client who had abdominal surgery yesterday. What method provides the most accurate data about resumption of peristalsis in the client?
A) Asking the client whether he or she has passed flatus (gas) B) Auscultating bowel sounds in all abdominal quadrants C) Counting the number of bowel sounds in each abdominal quadrant D) Observing the abdomen for symmetry and distention
A
The best and most reliable method for assessing the return of peristalsis following abdominal surgery is the client’s report of passing flatus within the past 8 hours or stool within the past 12 hours.
A nurse is educating a group of older adults about screening for colorectal cancer. Which statement by a group member indicates the need for further clarification about these guidelines?
A) "A barium enema every 5 years is a screening option." B) "I will need to have a routine colonoscopy every 5 years." C) "My routine flexible sigmoidoscopy every 5 years is OK." D) "The 'virtual' colonoscopy every 5 years is acceptable."
B
The 2010 guidelines indicate that routine screening with colonoscopy is performed every 10 years, not every 5 years. Other options are performed at 5-year intervals.
An outpatient clinic nurse is recovering a client who had a colonoscopy. The client asks for a drink. How does the nurse respond to the client’s request?
A) "After I hear bowel sounds, you can have a drink." B) "Twenty (20) minutes after the procedure was completed, you may have some liquids." C) "When you are able to pass flatus (gas), you can have a drink." D) "You can have fluids when you get home and are settled."
C
Fluids are permitted after the client’s peristalsis has returned. This is validated by the client’s passing flatus.
Which action does the nurse delegate to unlicensed assistive personnel (UAP) helping to care for a client with weight loss and anorexia?
A) Document a nutritional assessment. B) Lightly palpate the client's abdomen. C) Monitor the client after endoscopy. D) Obtain a stool specimen.
D
Obtaining a stool specimen is a skill included in UAP education and is within the UAP role.
A nurse is assessing a client who has come to the emergency department with acute abdominal pain. Which assessment finding is of greatest concern?
A) Bowel sounds are hypoactive in all quadrants. B) The client reports spasmodic cramping. C) The client says, "I have not had a bowel movement for 3 days." D) Bruising is noted around the client's umbilicus.
D
Bruising around the umbilicus (Cullen’s sign) is a sign of intra-abdominal bleeding.
Which client does the charge nurse on the adult medical unit assign to an RN who has floated from the outpatient GI unit?
A) 38-year-old who needs discharge instructions after having an endoscopic retrograde cholangiopancreatography (ERCP) B) 40-year-old who needs laxatives administered and effectiveness monitored before a colonoscopy C) 43-year-old recently admitted with nausea, abdominal pain, and abdominal distention D) 50-year-old with epigastric pain who needs conscious sedation during a scheduled endoscopy procedure
B
A nurse who has experience with chronic GI problems will have experience and training in instructing clients on colonoscopy preparation.
